HIV/AIDS

The goal of this training is to enable health workers to address the sexual and reproductive health (SRH) needs of HIV-positive women and adolescent girls by offering comprehensive SRH services within their own particular service-delivery setting. [from introduction]

This report outlines information from a literature review and field research pertaining to the key differences and similarities between the hospice ICHC model and other home-based care models used in South Africa; reviews the core elements of the ICHC model; and highlights best practices of the model. [adapted from introduction]

The main objections to the use of [antiretroviral therapies] in less-developed countries have been their high cost and the lack of health infrastructure necessary to use them. We have shown that it is possible to carry out an HIV treatment programme in a poor community in rural Haiti, the poorest country in the western hemisphere.

Published lessons learned from high HIV prevalence countries suggest that there are several key lessons available for any organisation that wishes to embark on an internal HIV/AIDS policy development process. This report contains first-hand experience by the Dutch Ministry of Foreign Affairs on its HIV/AIDS policy development process, plus comparative examples from various organisations. [from executive summary]

This report presents the finding from an study to determine the impact of HIV/AIDS on the public sector in Malawi. Section E, 3 establishes the impacts of HIV/AIDS on the Ministry of Health and Population and on health workers including statistics of attrition by occupational category in the health sector, morbidity and absenteesim, vacancy levels. It also analyzes effect on health worker workload, discusses the impact on productivity and performance, the financial implications, impact on service provision, and institutional vulnurability to HIV/AIDS.

This news article presents a study in Uganda that found HIV-positive Ugandans are twice as likely to quit antiretroviral therapy (ART) if they also use traditional herbal medicine. It suggests that the integration of traditional healers into modern medical practice needs to be handled more cautiously and that rather than shunning traditional healers, the solution is to work closely with them. [adapted from author]

This report focuses on the impact of human resource shortages witnessed by MSF teams in four southern African countries - Lesotho, Malawi, Mozambique, and South Africa. While the focus is largely on nurses in rural areas, it should be acknowledged that health staff is lacking across the spectrum - from doctors to laboratory technicians to pharmacists - at all levels of care. In all these cases the need for access to ART, as well as other health needs, is outstripping human resource capacity. [from introduction]

Hospitals are workplaces in which HIV has double significance. Needlestick accidents link patients, healthcare workers and cleaning staff through the risk of occupational exposure to HIV. Additionally, concern over needlestick injuries may embody HIV stigma, discrimination and fear. This paper draws on qualitative research from a one-year case study at a large, private South African healthcare company that runs a number of hospitals across the country. Issues surrounding needlestick injuries were discussed with hospital managers, union members, infection-control nurses, health and safety representatives, HIV/AIDS counsellors, and general nursing staff. [from abstract]

The Nigerian national ARV treatment training programme was conceived to meet the human resource needs in hospitals providing ARV therapy. This paper reports on the evaluation of the training programme. It examines knowledge and skills gained, and utilization thereof. Recommendations are made for improved training effectiveness and for specific national policy on training, to meet the demand for scaling up therapy to the thousands who need ARV. [from abstract]

This handbook explains why a gender and human rights strategy is a better approach for achieving results in curbing the HIV/AIDS epidemic It also shows you how to do it by providing the necessary information and techniques for incorporating gender and human rights into HIV/AIDS training. [from introduction]

Funding for scaling-up antiretroviral treatment (ART) in low-income countries has increased substantially, but the lack of human resources for health (HRH) is increasingly being identified as an important constraint for scaling-up ART. ART is labour intensive. Important reductions in doctor-time per patient can be realized during scaling-up. The doctor-based ART delivery model analysed seems adequate for Cambodia. However, for many districts in sub-Saharan Africa a doctor-based ART delivery model may be incompatible with their HRH constraints. [from abstract]

This assessment evalutes the RACHA program in Cambodia which was intended to strengthen the capacity and sustainability of the public and private sectors to deliver quality reproductive health and child survival services. The five technical intervention areas were birth spacing, STD/HIV prevention, safe motherhood, childhood diarrhoeal diseases and micronutrient deficiences. One of the key intermediate results identified within these areas was inproved human resource capacity to address these issues. [adapted from author]

This presentation was given as part of the Christian Health Association’s Conference: CHAs at a Crossroad Towards Achieving Health Millennium Development Goals. It provides an excellent overview of the challenges of Malaria and HIV/AIDS ; discusses the human resource needs in light of these challenges; and how to build and maintain capacity. [from author’s description]

In response to the HIV/AIDS crisis, Namibia’s public health sector is carrying out a comprehensive strategy to rapidly hire and deploy professional and non-professional health workers with the aim of providing comprehensive care, counseling and testing, as well as antiretroviral therapy (ART) and prevention of mother-to-child transmission (PMTCT). [from executive summary]

The AIDS Support Organization (TASO) administers a home-based program in Uganda that gives people in poor and rural settings access to antiretroviral therapy (ART) and services. The program’s innovation lies in shifting delivery of most clients’ follow-up activities at home to field officers, a new cadre of degree and diploma holders from the social sciences and education. Field officers ensure adherence to ART, refill clients’ medications and perform various activities, from voluntary counseling and testing to education to promoting family and community support. [from executive summary]

This document brings together the promising practices identified by the PVO community. Our definition of promising is purposefully broad to include the many ideas and experiences of different organizations that seem likely to combat HIV/AIDS successfully. [from foreword]

The manual is designed to help the ILO’s partners understand the issues and apply the ILO Code of Practice on HIV/AIDS and the world of work. The Code is at the core of the ILO’s Programme on HIV/AIDS, providing guidance to governments, employers and workers, as well as other stakeholders, on national action plans and workplace policies and programmes to combat HIV/AIDS.

The objective of this code is to provide a set of guidelines to address the HIV/AIDS epidemic in the world of work and within the framework of the promotion of decent work. The guidelines cover the following key areas of action: prevention of HIV/AIDS; management and mitigation of the impact of HIV/AIDS on the world of work; care and support of workers infected and affected by HIV/AIDS; elimination of stigma and discrimination on the basis of real or perceived HIV status. [from preface]

This report examines the workforce issues surrounding HIV/AIDS service delivery. At the request of the Government of Rwanda, data were collected on current health sector staffing and from 20 public and private facilities of various sizes and characteristics on the time required to provide HIV/AIDS services and the quality of those services. The report presents data relative to the numbers of clients needing different types of HIV/AIDS services, providers’ degree of compliance with service delivery standards, and the time it takes to provide services.

The most pressing challenge to achieving universal access to highly active anti-retroviral therapy (HAART) in sub-Saharan Africa is the shortage of trained personnel to handle the increased service requirements of rapid roll-out. Overcoming the human resource challenge requires developing innovative models of care provision that improve efficiency of service delivery and rationalize use of limited resources. We conducted a time-series intervention trial in two HIV clinics in central Mozambique to discern whether expanding the role of basic-level nurses to stage HIV-positive patients using CD4 counts and WHO-defined criteria would lead to more rapid information on patient status (including identification of HAART eligible patients), increased efficiency in the use of higher-level clinical staff, and increased capacity to start HAART-eligible patients on treatment.

This study documents the contribution made by religion and religious entities to the struggle for health and wellbeing in Zambia and Lesotho, in a context dominated by poverty, stressed public health systems and the HIV/AIDS pandemic. By mapping and understanding these Religious Health Assets (RHAs), the study calls for a greater appreciation of the potential they have for the struggle against HIV/AIDS and for universal access and offers recommendations for action by both public health and religious leaders at all levels.

Recent efforts to improve maternal health have focused on skilled attendants and emergency care at health facilities. Skilled birth attendants and access to emergency obstetric care are essential to saving mothers lives. In developing countries, 60 million women give birth at home without skilled care and with high maternal and neonatal mortality. Nearly all essential newborn care can be provided safely, effectively, and at a low cost at the household level. The same is true for care of the mother, and many effective interventions can be implemented at the household and community level that will save mothers’ lives.

This Praxis Note provides an overview of the impact of HIV/AIDS on the Malawi health care system and on the organisational capacity of Mulanje Mission Hospital. It describes the experiences and lessons learnt from a capacity building program designed to address capacity deficits and erosion caused by HIV/AIDS attrition. Less emphasis was placed on external training courses and increasing attention given to short-course inputs and distance learning. [from introduction]

This presentation gives an outline of the current challenges and opportunities for HRH in the Sub-Saharan Africa AIDS crisis, some possible solutions, key messages and ways forward.

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Using a representative sample of 478 doctors, nurses, and lab technicians working with people living with HIV/AIDS (PLWHA), a cross-sectional study was conducted to assess the impact of the AIDS epidemic on medical care systems and service providers in China. The study findings suggest that improved institutional support for AIDS care at the facility level and HIV-related stigma reduction intervention are crucial to maintain a high quality performance by the workforce in the health care system. [from publisher’s description]

This report on the Consultation on AIDS and Human Resources for Health, WHO, Geneva, 11-12 May, 2006 outlines the Treat, Train Retain plan to address AIDS and HRH. The plan comprises three sets of elements: a package of HIV treatment, prevention, care and support services for health workers in countries affected by HIV (Treat); measures to empower health workers to deliver universal access to HIV/AIDS services (Train); and strategies to retain health workers in the public health system, including financial and other incentives and strategies to improve pay and working conditions and manage the migration of health care workers (Retain).

Strengthening access to a range of HIV-related services for those in need and promoting communication among service providers requires a formalized referral network of providers. However, little information about how to create these networks and few standardized tools to facilitate effective network functioning are available. This document aims to describe several models of referral networks and to provide tools and instructions that can be adapted to different settings.

This study describes the work of the Choose to Care initiative of the Catholic Church in Southern Africa which began in 2000. It shows that effective scaling-up of programmes in the response to HIV does not necessarily have to be the expansion of a single central service. Working through the diocesan and parish system,…the Catholic Church scaled up service provision by the replication of smaller scale programmes rooted in and responsive to the needs expressed by local communities in this five-country area.

The 2006 Review seeks to provide a South African perspective on prevailing international public health issues, and in particular provides an opportunity to reflect on progress to achieving the Millennium Development Goals many of which are linked to maternal and child health. It also seeks to stimulate debate and critical discourse, to provide a platform for assessing progress and to identify key gaps and opportunities for future action that is realistic and sustainable. [from foreword]

These revised and expanded guidelines aim to help [national nursing associations], nursing and midwifery personnel, nurse managers, employers and others to address the educational needs and ethical responsibilities of nursing and midwifery personnel in reducing transmission of HIV/AIDS, HBV, HCV and tuberculosis; develop strategies for a safer work environment and increased protection for nursing and midwifery personnel; and address the socioeconomic welfare issues related to the health care needs, compensation and financial security of HIV-positive nursing and midwifery personnel.